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.  V 


WORKS  OF  DR.  H.  B.  BASHORE 

PUBLISHED    BY 

JOHN  WILEY  &  SONS,  INC. 


Overcrowding  and  Defective  Housing  in 
the  Rural  Districts. 

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Published  by  THE  F.   A.    DAVIS   CO. 
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Overcrowding   and 
Defective   Housing 

in    the  Rural   Districts 


Overcrowding  and 
Defective  Housing 

in  the  Rural  Districts 


BY 

DR.  HARVEY  B.  BASHORE 

Inspector  for  Pennsylvania  Department  of  Health 

AUTHOR  OF 

"The  Sanitation  of  a  Country  House,"  "The  Sanitation  of  Recreation 
Camps  and  Parks,"  "Outlines  of  Practical  Sanitation" 


FIRST   EDITION 
FIRST  THOUSAND 


NEW  YORK 
JOHN  WILEY  &  SONS,  Inc. 

London  :    CHAPMAN    &   HALL,   Limited 
1915 


145515 


Copyright,  1 91  5,  by 
HARVEY   B.    BASHORE 


c         <      *    < 


Publishers  Printing  Company 
207-217  West  Twenty-fifth  Street,  New  York 


DEDICATED  TO  THE 

MEMORY  OF 

FATHER  AND  MOTHER 


PREFACE 

When  we  first  began  to  investigate  this 
subject  it  was  hard  to  beHeve  that  real 
overcrowding  existed  in  the  country  dis- 
tricts, but  the  more  the  subject  was 
studied  the  more  the  fact  became  ap- 
parent. I  Httle  imagined  that  we  had 
conditions  in  our  own  small  towns  and 
villages  almost  as  bad  as  I  had  seen  in  the 
great  East  Side  on   Manhattan   Island. 

;       Yet  why  not?    Greed  for  gold  is  just  as 

'       strong  in  the  country  speculator  as  in  the 
city  millionaire,  and  the  owner  of  a  few 

t<      lots  is  going  to  make  the  most  of  them — 

>       if  he  has  a  chance. 

The  observations  noted  in  this  little 

ix 


X  Preface 

work  were  made  for  the  most  part  in  a 
typical  rural  farming  community,  inhab- 
ited by  native-born  Americans.  That 
conditions  are  vastly  worse  in  the  great 
mining  and  manufacturing  districts,  no 
one  can  doubt.  Many  thanks  are  due  to 
Miss  Lucy  Shellenberger,  visiting  nurse 
for  the  Pennsylvania  Department  of 
Health,  for  assistance  in  preparing  the 
work,  collecting  data  of  the  various 
"  lung"  houses,  and  reading  the  MS. 

West  Fairview,  Pa.,  February,  1915. 


CONTENTS 

CHAPTER  PAGE 

I.    Land  Overcrowding 13 

II.    House  Overcrowding 26 

III.  Defective  Building 51 

IV.  Overcrowded  and  Defective  Schools 66 

V.    Results 80 


XI 


Overcrowding  and    Defective 
Housing  in  the  Rural  Districts 

CHAPTER  I 

LAND  OVERCROWDING 

Overcrowding  the  land  with  buildings 
is  not  so  very  common  in  the  country,  yet 
it  does  occur  in  many  villages  and  small 
towns,  especially  in  those  which  are  on 
the  "boom"  from  some  rapidly  increasing 
industry,  and  much  of  this  overcrowding 
in  villages  is  due  to  the  "row."  We  can 
readily  understand  how  building  in  rows 
may  be  necessary  in  the  great  cities,  but 
it  surely  is  not  necessary  in  villages  and 
small  towns:  indeed,  I  have  seen  the 
"row"  far  out  in  the  country,  where  land 

13 


14  Rural  Housing 

is  almost  valueless.  These  barrack-like 
houses — and  I  know  one  small  town 
where  a  certain  small  row  is  called  the 
barracks — are  perhaps  satisfactory  for 
soldiers,  but  for  raising  families  they  are 
anything  but  what  they  should  be.  At 
first  thought  you  will  say  there  is  no  over- 
crowding, but  if  you  will  think  a  little 
further,  you  will  see  that  there  is  too  much 
building — probably  we  ought  to  call  it 
defective  building — on  each  lot. 

This  overcrowding  the  land  with  houses 
does  not,  of  course,  injure  the  land  nor 
thee  houses,  but  it  is  likely  to  injure  the 
occupants,  for,  necessitating  lack  of  air 
and  sunshine  in  some  of  the  rooms  of  the 
building,  it  leads  to  the  consequent  evil 
of  house  and  room  overcrowding,  for  the 
less  air  and  sunshine  a  house  has,  the  less 
people  it  can  properly  house.  There  may 
be  room  overcrowding  in  the  isolated 
house  standing  in  the  middle  of  a  ten-acre 


Land  Overcrowding  15 

field,  but  it  is  more  likely  to  occur  when 
the  land  is  crowded  with  buildings,  per- 
mitting the  influx  of  more  families  caused 
by  the  apparent  greater  amount  of  hous- 
ing space  and  cheaper  rental. 

There  is  hardly  a  village  street  which 
approaches  anything  like  the  width  of  the 
streets  in  the  great  cities — yet  adjoining 
these  narrow  village  streets  as  much  land 
is  covered  relatively  by  buildings  as  in  the 
city;  on  the  other  hand,  although  the 
village  houses  do  not  approach  the  height 
of  the  city  houses  the  real  condition  is 
even  worse  than  in  the  city,  for  the  narrow 
street  is  frequently  lined  on  both  sides  by 
low,  bushy  trees,  and  the  houses,  due  to 
the  lack  of  height,  have  such  low  ceilings 
that  there  is  really  less  circulation  of  air 
than  in  the  ordinary  city  home. 

In  Fig.  I  is  shown  an  example  of  one 
of  these  village  "rows"  which  has  over- 
crowded   the    land.      These    lots,    only 


i6  Rural  Housing 

seventy-two  feet  wide,  are  completely 
covered  at  one  end  by  a  building  which  is 
divided  into  six  so-called  houses:  each 
house  contains  two  rooms  downstairs  and 
two  upstairs.  The  end  houses  alone  of 
such  a  building  can  have  Hght  and  air  on 
more  than  two  sides,  but,  unfortunately, 
these  ends  are,  in  the  present  instance, 
furnished  with  very  small  windows,  so 
that  these  end  houses  are  very  little  bet- 
ter than  the  intervening  ones.  These  lots 
should  contain  just  about  one -half  as 
many  houses  and  the  increased  rental  de- 
rived from  the  better  houses  would,  prob- 
ably, in  the  end,  yield  about  as  much  in- 
come from  the  land  as  when  it  was 
overcrowded  with  the  "row."  This  in- 
sanitary row  is  situated  in  a  town  of  less 
than  a  thousand  people,  but  some  years 
ago  when  a  Httle  "boom"  struck  the 
place,  everybody  wanted  to  get  rich 
quick,  and  the  owner  of  these  lots  found 


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Land  Overcrowding  19 

that  he  could  rent  many  small  houses 
profitably. 

Of  course  it  is  well  to  remember  that  by 
proper  building  many  more  people  can  be 
housed  on  a  given  lot  than  by  the  im- 
proper building  characterized  by  the  usual 
village  "row."  However,  to  put  up 
buildings  which  would  be  proper  for 
housing  many  people  would  necessitate 
more  expense  than  the  value  of  the  land 
would  justify,  consequently  it  is  better  to 
have  relatively  less  building  and  house 
relatively  fewer  people  on  the  village  lot. 

I  was  once  driving  in  a  wild  mountain 
valley  in  Pennsylvania  and  came  upon  a 
settlement  made  up  of  the  houses  of  the 
workmen  of  a  nearby  industry:  rather, 
there  were  no  houses;  only  a  long  row, 
divided  into  compartments,  called  houses 
in  the  company's  books.  The  conditions 
here  were  scarcely  better  than  a  city 
block,  and  the  inhabitants — pale,  sallow. 


20  Rural  Housing 

dirty,  and  unkempt,  from  living  in  badly 
ventilated  rooms — showed  the  typical 
countenances  of  the  overcrowded.  Yet 
right  here  there  was  land  in  plenty,  land 
everywhere  that  nobody  wanted — land 
for  ten  dollars  an  acre,  and  yet  defective 
housing  conditions  crowded  the  land  be- 
cause the  company  employing  these  people 
were  too  penurious  and  too  careless  to 
build  houses  fit  for  human  habitation. 

Another  improvement  in  the  money- 
making  scheme  of  overcrowding  is  to 
build  additional  houses  on  the  rear  end  of 
the  lot;  very  frequently  the  stable  being 
changed  into  a  dwelling-house.  I  knew  an 
instance  in  which  this  happened  in  a 
small  town:  a  man  bought  the  stable  at 
the  end  of  a  certain  lot — a  lOO-foot  lot — 
and  fitted  it  up  as  a  house  and  lodged 
therein  his  numerous  family.  He  could 
have  gotten  an  entire  lot  and  house  for 
the  same  cost  a  mile  or  so  farther  away, 


Land  Overcrowding  21 

but  he  preferred  the  crowding  to  the 
longer  distance  from  the  village  centre. 

I  know  of  a  case  where  a  corner  lot,  109 
feet  long  and  58  feet  wide,  was  by  this 
arrangement  so  covered  with  buildings 
that  barely  25  per  cent  of  the  lot  was  un- 
occupied; but  25  per  cent  unoccupied  is 
the  rule  in  some  of  the  large  cities,  yet 
here  was  a  village  lot  almost  imitating  the 
plans  of  the  big  city.  Now,  of  course,  one 
instance  of  this  class  of  overcrowding 
might  not  be  so  bad,  but  the  tendency  is 
there,  and  sooner  or  later  there  will  be  a 
row  of  houses  facing  the  street  and  a  row  in 
the  alley.  At  first,  as  there  is  a  demand  for 
houses,  a  fairly  good  class  of  people  may 
occupy  them,  but  as  the  houses  depreciate 
and  the  demands  lessen,  a  poorer  and  more 
negligent  class  move  in  and  the  locality 
degenerates  into  a  veritable  "slums." 

In  Fig.  2  is  shown  another  phase  of 
rural  overcrowding  the  land,  which  I  sup- 


22  Rural  Housing 

pose  does  not  happen  very  often,  and 
that  is  an  actual  rear  tenement, — small 
and  insignificant  the  building  is,  yet  nev- 
ertheless it  differs  only  in  degree  from  the 
big  city  tenement — the  fundamental  prin- 
ciple is  just  the  same.  It  probably  came 
about  through  a  re-survey  of  the  street 
which  left  the  old  house  some  distance 
back  from  the  pavement:  then  an  addi- 
tional building  was  put  up  in  the  front 
and  the  old  rear  building  rented  as  a 
Chinese  laundry — almost  as  bad  as  some 
of  the  buildings  in  the  Chinese  quarter  in 
New  York. 

A  similar  case  worth  recording  is  that 
in  which  an  entire  corner  lot  is  covered 
with  a  building,  so  much  so  that  the  toilet 
accommodations  are  on  the  street.  This 
result  was,  to  be  sure,  brought  about  very 
slowly.  A  bankrupt  speculator  owned  the 
building  and  lot,  and  gradually  sold  off 
the  lot  to  his  neighbor;  in  fact,  sold  every- 


1-  iG.  2. — An  Actual  Rear  Tenement  in  a  Small  Town. 


Land  Overcrowding  25 

thing  except  the  house,  and  that  his 
neighbor  didn't  want! 

Of  course  these  are  all  isolated  instances 
given  only  as  samples  of  conditions  which 
exist  in  many  places:  they  serve  to  show 
it,  possibly,  at  its  worst.  There  are,  how- 
ever, few  towns  and  villages  which  do  not 
have  some  of  these  defects:  they  are 
mostly,  I  think,  in  the  older  ones.  In  the 
newer  towns  it  is  less  evident. 

How  to  prevent  this  condition  from 
arising  is  not  so  easy  save  by  proper  edu- 
cation of  the  people.  The  building  of 
rows  and  shacks  begins  quite  often  before 
the  village  is  incorporated,  while  it  is  still 
the  "country," — only  with  township  su- 
pervision which  does  not  amount  to  much 
as  long  as  a  man  keeps  to  his  own  land  and 
pays  his  taxes.  When  the  straggling  houses 
become  incorporated  into  a  town,  proper 
building  rules  can  be  made  and  enforced, 
but  often  already  the  damage  is  done. 


CHAPTER   II 

HOUSE  AND   ROOM   OVERCROWDING 

House  or  room  overcrowding  is  the 
common  housing  defect  met  with  in  the 
country — sometimes  due  to  the  ill-con- 
structed building,  poverty,  or  thoughtless 
landlord,  but  in  many  instances  due  to  the 
carelessness  and  shiftlessness  of  the  people 
themselves.  The  "house  in  the  row" 
mentioned  in  Chapter  I  is  very  often  re- 
sponsible for  a  great  deal  of  overcrowding ; 
but  not  all  rows  are  overcrowded.  I  have 
seen  instances  where  small  families  lived 
in  such  limited  quarters  under  proper  san- 
itary conditions,  but  this,  I  think,  is  the 
exception.    The  "house  in  the  row"  very 

often  contains  only  four  rooms,  so  it  is 

26 


Fig.  3. — Seventeen  People  Once  Lived  in  this  "Row"  of 

Three  Houses. 


House  and  Room  Overcrowding  29 

very  evident  that  when  more  than  three, 
or  at  the  most  four,  people  Hve  in  such  a 
house,  with  only  small  windows  front  and 
back,  there  will  be  overcrowding  and  with 
it  lack  of  fresh  air  and  sunshine. 

As  an  illustration  of  this  overcrowding, 
take  the  row  shown  in  Fig.  3.  Supposed 
to  be  three  houses:  at  one  time  this  build- 
ing contained  seventeen  people,  and  as 
there  are  only  four  and  one-half  bed- 
rooms (if  there  can  be  such  a  thing  as  half 
a  room)  in  the  whole  row — one  and  one- 
half  in  each  house — there  was  evidently  a 
vast  amount  of  overcrowding.  The  gable 
ends  in  this  case  have  one  small  window: 
much  better,  however,  than  some  others, 
which  have  no  windows.  Though  the  end 
houses  in  such  a  row  are  almost  as  bad  as 
the  middle  one,  they  are  still  considered 
by  far  the  best  in  the  row,  as  is  shown  by 
the  increased  rental  paid  for  them. 

Why  are  such  houses,  insanitary  they 


30  Rural  Housing 

surely  are,  built  in  our  towns  and  villages? 
Simply  because  the  owner  hopes  to  make 
ID  or  12  per  cent  on  his  investment;  and 
many  an  opulent  family  lives  on  the  pro- 
ceeds of  a  "rotten  row"  that  is  a  disgrace 
to  modern  sanitary  knowledge.  These 
people,  the  proprietors,  I  mean — gener- 
ally the  best  people  in  their  respective 
communities, — fail  to  realize  that  insan- 
itary dwellings  built  in  sunless  rows,  even 
on  another  street,  are  a  menace  to  their 
own  health. 

In  the  photograph  (Fig.  4)  is  shown  an 
example  of  gross  overcrowding  in  a  certain 
old-fashioned  country  town.  Each  wing 
of  this  building  is  called  a  home  and 
rented  to  different  families,  although  con- 
sisting of  but  one  room;  one  of  these  is 
occupied  by  a  mother  and  two  sons — one 
eighteen  years  old :  all  three  live  and  eat 
in  this  single  room,  and  all  three  sleep  in 
the  one  bed  (Fig.  5).    The  other  house  is 


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House  and  Room  Overcrowding  35 

occupied  by  a  man,  wife,  and  two  children. 
Bad  it  surely  is,  yet  this  house  is  owned  by 
very  respectable  people  who  apparently 
fail  to  recognize  the  iniquity  of  renting 
such  a  house  in  the  manner  given. 

The  overcrowding  mentioned  above  is 
in  a  great  measure  due  to  environment 
and  landlord,  the  people  themselves  not 
being  responsible  for  the  existing  condi- 
tions. On  the  other  hand,  there  is  very 
much  overcrowding  due  wholly  to  the 
habits  and  ignorance  of  the  people  them- 
selves. For  example,  a  nurse  from  one  of 
the  State  Dispensaries,  in  her  visiting 
work,  came  across  a  certain  farmhouse 
where  five  people  were  accustomed  to 
sleep  in  one  not  very  large  bedroom, 
which  had  only  one  small  window,  and 
even  that  was  nailed  shut;  one  of  these 
five  had  incipient  tuberculosis.  These 
people  were  well-to-do  farmers  living  in  a 
large  twelve-room  stone  house,  and  sim- 


36  Rural  Housing 

ply  crowded  into  one  room  for  the  sake 
of  mistaken  economy — presumably  to 
save  coal  and  wood.  The  picture  of  this 
house  (Fig.  6)  shows  it  to  be  a  very  com- 
fortable and  airy  building  which  would  be 
entirely  suitable  for  an  even  larger  family 
to  live  in,  under  proper  sanitary  conditions. 
Another  form  of  this  overcrowding  is 
seen  in  certain  mountain  districts  of 
Pennsylvania,  and  I  suppose  it  may  be 
very  much  the  same  in  other  States.  It 
has  been  noted  in  these  places  that  the 
natives  do  not  have  the  strong,  healthy 
build,  and  a  color  redolent  of  health,  but 
the  thin,  pale,  and  wan  features  of  those 
suffering  from  the  lack  of  pure  air.  Yet 
these  people  live  in  the  purest  of  God's 
fresh  air,  in  places  akin  to  those  in  which 
we  build  our  Sanatoria.  Why  is  it?  In 
many  instances  the  explanation  seems  to 
be  dependent  on  the  personal  habits  of 
these  mountaineers,  who,  on  the  advent 


House  and  Room  Overcrowding  39 

of  winter,  "hole  up,"  a  good  deal  like 
certain  animals.  They  lay  in  a  supply  of 
wood,  but  as  wood  is  becoming  scarce 
and  they  are  generally  lazy  and  shiftless, 
the  supply  is  not  over-abundant,  so  they 
economize  space  and  heat,  and  have  fire 
only  in  the  cook-stove  in  the  kitchen. 
Windows  and  unnecessary  doors  are  nailed 
shut,  and  here  around  the  stove  the  family 
spend  most  of  the  winter,  eat  and  sleep  in 
one,  or  at  the  most  two,  rooms:  and  the 
result?  The  faces  you  see  here  in  these 
mountain  homes  remind  you  of  the  faces 
you  see  in  the  densely  crowded,  insanitary 
tenements  of  the  cities.  The  complete 
outdoor  life  of  summer  is  barely  able  to 
combat  the  bad  air  and  lack  of  air  during 
the  winter  months,  and  a  chronic  con- 
dition of  lowered  vitality  results. 

In  the  photograph  (Fig.  7)  is  shown  one 
of  these  mountain  homes — a  typical  one. 
The   bedroom    of    this   house    (Fig.    8), 


145515 


40  Rural  Housing 

which  is  the  loft  with  a  floor  surface  fifteen 
feet  square,  is  habitually  used  by  eight 
people.  Three  sleep  in  one  bed,  two  in 
another,  two  more  in  still  another,  and  the 
mother,  who  is  tubercular,  sleeps  on  the 
cot  in  the  corner.  One  would  hardly  be- 
lieve it  possible  that  such  overcrowding 
exists,  yet  there  are  many  cases  like  this 
among  these  mountain  people.  When  I 
remonstrated  with  the  owner,  who  is  well 
known  to  me,  about  his  insanitary  living, 
he  admitted  that  conditions  were  bad  and 
that  he  had  hoped  to  build  an  addition  to 
his  house,  but  he  was  short  of  funds.  I 
knew  he  was  telling  the  truth,  and  as  I 
was  not  anxious  to  help  him  negotiate  a 
loan,  I  found  it  profitable  to  change  the 
subject;  loaning  money  to  such  does  not 
overcome  the  defect,  or  if  it  did,  it  would 
certainly  be  temporary. 

A  similar  example  of  this  overcrowding 
in  a  mountain  home  is  shown  in  the  pho- 


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House  and  Room  Overcrowding  45 

tograph  (Fig.  9);  this  small  shack — one 
could  hardly  call  it  a  house — contains 
seven  people.  The  building  is  composed 
of  four  rooms — kitchen,  sitting-room,  and 
two  bedrooms:  one  of  which  is  used  by 
four  people  and  the  other  by  three.  The 
rooms  are  so  diminutive  and  the  windows 
so  small  that,  although  these  people  live 
right  on  the  foothills  of  a  wild  mountain 
country,  they  are  living  under  very  badly 
overcrowded  conditions  and  are  paying 
the  penalty — tuberculosis. 

A  common  phase  of  overcrowding  in 
the  country,  just  as  in  the  city,  is  the 
"lodger  evil,"  especially  in  some  of  those 
districts  which  are  rapidly  developing.  I 
know  of  a  certain  family  in  a  certain  small 
town — a  typical  case — in  which  this  con- 
dition exists.  The  family  of  five  adults 
are  living  in  a  six-room  house  and  take 
one  boarder.  They  are  frugal  and  indus- 
trious Americans,  and  are  trying  to  pay 


46  Rural  Housing 

for  their  small  home;  and  they  are  doing 
it,  but  at  the  high  price  of  overcrowding; 
for  one  daughter  has  died  of  tuberculous 
meningitis  and  another  at  present  has  the 
appearance  of  developing  the  pulmonary 
form  of  the  dread  disease. 

The  worst  case  of  overcrowding,  how- 
ever, that  I  have  ever  seen  appeared  one 
day  last  summer  when  I  prepared  to  ad- 
minister immunizing  doses  of  antitoxin  to 
an  Italian  family  during  an  epidemic  of 
diphtheria:  thirteen  children  lined  up  to 
take  their  "medicine";  in  addition,  there 
were  six  adults,  making  nineteen  human 
beings  living  in  one  house,  and  this  house 
containing  only  six  rooms.  Where  these 
people  slept  was  almost  a  mystery,  for 
there  were  but  three  beds  in  the  house. 
They  simply  stretched  out  on  the  floor; 
and  their  pale  and  sallow  faces  told  the 
cost — the  great  cost — of  overcrowding. 
You  might  think  this  was  a  Hester  Street 


i'lG.  9. — Seven  I^eople  Live  in  this  Four-Room  Shack,  Over- 
crowded, When  There  are  Acres  Unoccupied. 


House  and  Room  Overcrowding  49 

tenement,  but  it  happened  to  be  a  farm- 
house, situated  in  one  of  the  most  beauti- 
ful valleys  of  Southern  Pennsylvania,  far 
from  the  smoke  and  din  of  cities.  The  old 
idea  that  the  country  is  such  a  healthful 
place  to  live  in  is  good  only  so  far  as  the 
country  is  fresh  from  the  hand  of  the 
Lord,  for  Man's  make-over  in  the  country 
is  generally  poor — very  poor. 

And  now  a  word  about  the  factory:  we 
used  to  have  an  idea  that  the  factory, 
often  insanitary  and  unventilated,  was  a 
big  item  in  the  problem  of  defective 
housing,  simply  because  factory  workers 
so  often  show  the  ill  effects  of  bad  hous- 
ing. The  real  fact  seems  to  be  that  most 
of  these  workers  live  in  very  insanitary 
homes — badly  housed  and  badly  fed — in 
an  environment  tending  to  lack  of  sleep 
and  rest,  which  often  ends  in  dissipation: 
and  that  it  is  the  home -life  environment, 
and  not  the  factory,  which  brings  disaster 


50  Rural  Housing 

to  this  class.  In  taking  a  census  of  cer- 
tain workers  in  a  factory  in  a  rural  town, 
it  was  found  that  those  whose  home  con- 
ditions and  personal  habits  were  good 
were  just  as  healthy  and  successful  as 
those  who  didn't  work  in  the  factory. 
The  factory  people,  in  this  investigation, 
who  were  suffering  from  physical  dete- 
rioration had  invariably  bad  home  con- 
ditions, or  else  bad  personal  habits. 


CHAPTER   III 

DEFECTIVE    BUILDING 

A  GREAT  deal  of  the  bad-housing  con- 
ditions in  the  country  is  due  to  defective 
building.  In  the  country  an  architect  is 
rarely  employed:  the  country  carpenter, 
or  a  self-made  contractor,  does  the  work, 
neither  of  whom  knows  the  first  principle 
of  construction:  their  sole  object  is  to  get 
the  most  building  on  the  lot  for  the  least 
money.  Very  often  the  owner  himself 
plays  the  part  of  the  architect,  and  then 
conditions,  very  often,  are  worse  than 
otherwise.  As  a  result  of  this  state  of 
affairs  many  country  houses  have  gross 
sanitary  defects,  which  could  have  been 

easily  remedied  by  a  little  forethought. 

51 


52  Rural  Housing 

As  was  mentioned  several  times  before, 
one  of  the  greatest  defects  in  rural  hous- 
ing is  the  "row,"  which  of  itself  would  not 
be  bad — it  isn't  in  the  large,  well-aired 
and  roomy  house  of  a  great  city — if  the 
construction  was  properly  made,  but  where 
window  space  is  neglected  or  sacrificed 
and  sunshine  lessened,  when  ceilings  are 
low,  as  they  always  are  in  such  buildings, 
air-space  is  so  curtailed  that  the  building 
must  contain,  of  necessity,  serious  faults; 
and  when  you  find  a  room — a  bedroom 
where  there  are  no  windows — you  might 
almost  believe  you  were  transported  to 
some  of  the  places  in  New  York  which 
Mr.  Riis  tells  about  in  his  "Battle  with 
the  Slum."  Yet  such  things  are  not 
mythical  in  the  country:  I  can  show  you 
a  windowless  bedroom,  and  occupied  too, 
in  a  certain  house  in  a  country  town  of 
less  than  10,000  inhabitants.  A  good 
many  of  these  bad  conditions  are  brought 


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Defective  Building  55 

about  by  the  remodeling  of  old  buildings 
without  the  supervision  of  an  architect. 
If  ever  an  architect  is  needed,  it  is  when 
an  old  building  is  made  over — ^here, 
surely,  expert  advice  is  necessary.  Of 
course,  such  serious  defects  are  not  so 
frequent,  but  they  occur  often  enough  to 
warrant  the  attention  of  those  interested 
in  improving  housing  conditions. 

Small  windows  and  lack  of  windows 
are  the  great  faults  found  in  rural  build- 
ing. In  Fig.  10  is  shown  a  house  of  this 
sort  which  might  be  considered  a  type  of 
such  conditions — isolated  and  open  on 
all  sides,  it  should  be  ideal  for  health,  but 
the  small  windows  give  great  lack  of  sun- 
shine and  ventilation;  one  window,  two 
by  three  feet,  is  the  only  opening  on  the 
entire  side,  and  the  other  side,  I  am  sorry 
to  say,  is  just  the  same.  It  would  be 
interesting  to  know  what  was  passing 
through  the  mind  of  the  builder  who  de- 


56  Rural  Housing 

vised  such  a  form  of  architecture,  which 
certainly  may  help  to  account  for  the 
tuberculous  history  of  this  house,  which  is 
told  in  the  last  chapter. 

Another  example  of  this  defective  build- 
ing characterized  by  small  windows  is 
shown  in  the  photograph  (Fig.  11):  this 
probably  was  an  old  log-house,  made  over 
by  weather-boarding  and  converting  the 
original  loft  into  an  upper  room.  The  log- 
cabin  of  the  early  settler,  with  its  port- 
hole windows,  was  really  not  bad  building 
in  its  day,  for  the  inhabitants  of  those 
times  led  so  much  of  an  outdoor  life  and 
spent  so  little  time  indoors  that  what 
would  be  bad  housing  now  to  the  clerk, 
the  artisan,  the  mechanic,  and  the  farmer 
had  little  effect  on  the  frontiersman  and 
the  settler. 

The  damp  cellar  is  a  very  prominent 
defect  in  rural  building:  every  one  who 
lives  or  visits  in  the  country  knows  the 


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Defective  Building  59 

damp,  musty  odor  which  pervades  almost 
every  country  house,  especially  in  the  fall 
before  the  fires  are  started :  so  vastly  dif- 
ferent is  it  from  the  dry  atmosphere  of 
the  usual  city  house.  This  dampness  is 
surely  a  potent  factor  in  the  cause  of  the 
various  rheumatic  complaints  so  common 
in  most  rural  districts.  It  goes  without 
saying  that  the  proper  construction  of  a 
building  demands  a  dry  cellar  such  as 
ma}^  be  obtained  by  means  of  concrete  and 
damp-proof  course  in  the  foundation. 

With  the  elimination  of  damp  cellars, 
close  building  in  rows,  and  small  win- 
dows, much  of  the  defect  in  rural  housing 
would  be  overcome,  and  these  corrections 
can  usually  be  so  readily  accomplished 
that  the  only  excuse  for  their  existence  is 
thoughtlessness  or  ignorance.  It  is  hardly 
necessary  to  say  that  every  house  should 
have  open  space  all  around  it,  and  be  so 
situated  that  the  greatest  number  or  all 


6o  Rural  Housing 

of  the  rooms  receive  sunlight  part  of  the 
day,  as  there  is  no  disinfectant  or  de- 
oderant  equal  to  sunlight:  none  so  cheap 
and  none  to  make  up  for  its  absence.  This 
arrangement  can  very  readily  be  made  in 
the  country  on  account  of  the  abundance 
of  room;  indeed,  the  country  is  the  ideal 
place  for  building,  for  one  is  not  ham- 
pered by  other  dwellings  nor  excessively 
high  cost,  as  is  the  case  in  most  cities. 

In  many  places,  as  if  to  compromise 
with  the  "row,"  the  buildings  are  put  up 
double  so  as  to  house  two  families.  While 
this  is  vastly  better  than  row-building,  it 
is  not  quite  ideal;  it  approaches  it  and,  in 
most  instances,  would  be  rightly  classed  as 
good  building.  In  the  accompanying  pho- 
tograph (Fig.  12)  is  shown  a  picture  of  a 
street  in  a  small  town  built  more  or  less 
of  isolated  houses:  plenty  of  windows  and 
open  space  between  each  house  give  a 
vastly    different    appearance    from    the 


Defective  Building  63 

street  shown  in  Fig.  i,  which  was  taken 
in  another  district  of  the  same  town. 

A  point  which  is  worth  some  thought  is 
that  dilapidation  is  not  of  necessity  bad 
hygiene:  the  broken  fence,  the  unhinged 
gate,  the  shattered  window-pane,  and  the 
moss-covered  roof  look  careless  and  are 
careless,  but  under  cases  of  the  greatest 
dilapidation  I  have  seen  splendid  sanitary 
conditions.  Some  time  ago,  when  inves- 
tigating a  diphtheria  outbreak  in  a  moun- 
tain district,  I  visited  a  certain  house 
where  the  disease  was  reported  to  exist. 
The  dilapidation  of  the  premises  was 
striking,  indeed — fences,  doors,  windows, 
porch,  and  everything  else  were  broken 
and  upside  down.  The  health-officer  in 
formed  me  that  the  family  was  large,  and 
of  course  I  expected  to  find  conditions  bad. 
When  I  entered  the  house  I  was  surprised 
to  find  that  almost  every  precaution 
known  in  the  care  of  this  disease  was  in 


64  Rural  Housing 

force.  The  patient  was  isolated  in  an  ad- 
joining room:  she  had  her  own  dishes  and 
toilet  articles;  the  mother  remained  with 
her  as  nurse;  the  father  did  the  cooking 
and  caretaking  of  the  rest  of  the  family, 
and  all  absolutely  remained  out  of  the 
sick-room.  When  occasion  required  ad- 
mission to  an  upstairs  room,  instead  of 
going  through  the  sick-room  the  father 
climbed  up  a  ladder  on  the  outside;  in 
addition,  the  sick  child  and  all  the  rest  of 
the  family  received  antitoxin ;  it  is  needless 
to  state  that  there  was  only  one  case  of 
diphtheria  in  that  house. 

In  an  instance  which  came  to  my  notice 
a  few  days  ago,  I  found  a  case  of  typhoid 
fever  in  a  lop-sided,  broken-down  log-cabin 
in  a  Httle  mountain  community:  but  here, 
as  above,  the  dilapidation  didn't  count. 
The  patient  had  a  room  to  herself;  her 
own  dishes,  and  disinfectant  solutions 
right  beside  the  bed.     As  soon  as  the 


Defective  Building  65 

physician  had  pronounced  the  disease  to 
be  typhoid,  the  family  began  using  only 
boiled  water  for  drinking,  and  disinfected 
all  the  discharges  of  the  sick.  The  mother 
who  attended  her  washed  and  disinfected 
her  hands  as  carefully  as  any  trained 
nurse:  there  were  no  secondary  cases  in 
that  house.  So  much  for  general  sanita- 
tion in  dilapidated  homes:  when  it  comes 
to  overcrowding,  dilapidation  in  some  of 
the  houses  we  meet  would  be  a  boon,  and 
really  mean  more  air  and  sunshine,  and 
consequently  help  to  remedy  the  existing 
defect.  However,  we  do  not  recommend 
dilapidation  as  the  means  to  overcome 
sanitary  errors.  Dilapidation  is  unsightly 
and  unpleasant,  and  may  be  nothing  else, 
although  the  carelessness  and  shiftless- 
ness  which  breed  it  are  very  prone 
and  very  likely  to  breed  real  sanitary 
defects. 


CHAPTER   IV 

OVERCROWDED    AND     DEFECTIVE 
SCHOOLS 

While  the  home  life  is  vastly  more  im- 
portant than  the  school  life,  and  though 
the  sanitary  arrangements  of  the  sur- 
rounding farmhouses  are  usually  vastly 
worse  than  the  neighboring  schools,  yet 
it  is  quite  Hkely  that  the  country  school — 
overcrowded  and  with  glaring  sanitary 
faults — is  an  item  in  the  rural  health.  The 
little  one-room  schoolhouse  (Fig.  13),  so 
common  all  over  the  country,  has  turned 
out  some  great  and  good  men,  and  women 
too,  but  it  has  also  turned  out  many  that 
might  have  gotten  along  better  in  the 
world  if  their  physical  condition  and  wel- 

66 


Fig.  13. — The  Old-Fashioned  School  with  its  Usual  Pictur- 

ESQCE  Setting.     Note  Small  Window-Space. 

Photo  by  Mr.  James  McCormick,  Jr. 


Overcrowded  and  Defective  Schools        69 

fare  had  been  looked  after:  it  is  a  good 
thing  to  remember  that  real  progress  is 
not  the  progress  of  the  few  great  men,  but 
the  standard  and  average  of  the  plain, 
ordinary  citizen. 

Bad  enough,  indeed,  is  it  when  cities 
crowd  their  schools,  but  to  have  this  con- 
dition, as  is  often  the  case,  out  in  the 
country  seems  infinitely  worse.  The  fact 
is  that  all  city  children,  no  matter  what 
city  or  where,  attend  school  under  sani- 
tary conditions  far  ahead  of  anything  in 
the  country,  for,  like  the  rest  of  the  rural 
community,  the  school  has  been  sadly 
neglected,  and  the  days  when  Ichabod 
Crane  taught  in  Sleepy  Hollow  can  al- 
most be  duplicated  in  some  of  the  back 
settlements. 

In  many  of  these  schools  the  most 
prominent  fault  is  that  of  construction: 
that  entailing  in  turn  the  various  other 
abuses.    With  defective  housing  at  home 


70  Rural  Housing 

and  defective  conditions  at  school,  is  it 
any  wonder  that  many  country  children 
fall  far  below  the  standard  of  physical 
excellence?  Is  it  any  wonder  that  medi- 
cal inspection  of  rural  schools  shows 
country  children  to  be  just  as  defective, 
in  proportion,  as  city  children?  We  used 
to  think  that  the  country  was  such  a  good 
place  to  raise  children!  But  a  change  is 
taking  place,  even  in  the  country.  This 
very  day  I  happened  to  visit  a  certain 
two-room  country  school  (Fig.  14)  planned 
and  built  by  a  trained  architect — the  first 
of  its  kind  in  one  of  the  rural  counties  of 
Pennsylvania.  The  large,  light,  airy,  and 
well-ventilated  rooms  are  a  pleasure  to 
pupils,  teacher,  and  patrons:  a  vast  con- 
trast it  is  to  the  old-fashioned,  dingy 
room  of  the  past.  Yet  this  township  is  no 
richer  than  any  of  its  neighbors,  but  its 
school  board  is  awake  to  the  possibilities 
which    come    from    advancing    progress. 


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Overcrowded  and  Defective  Schools        73 

The  city  school  boards  employ  an  archi- 
tect: why  shouldn't  we  in  the  country? 
they  reasoned.  Nevermore  in  this  sec- 
tion will  the  self-made  contractor  play 
the  architect's  part. 

It  is  generally  conceded  that  a  school 
building  should  have  about  twenty  square 
feet  of  floor  surface  for  each  pupil,  con- 
sequently it  is  easy  to  draw  the  line 
against  overcrowding,  by  simply  calcu- 
lating the  number  of  pupils  to  be  ad- 
mitted; but  economic  conditions  change 
and  a  room  built  for  thirty  frequently  con- 
tains fifty.  The  air-space  per  pupil  should 
be  between  250  and  500  cubic  feet,  de- 
pending on  the  means  of  ventilation:  if 
there  is  no  special  arrangement  for  the 
admission  of  fresh  air,  the  greater  air- 
space— 500  cubic  feet — will  surely  not  be 
too  much.  In  an  ordinary  country  school 
— overcrowded,  of  course, — I  have  seen 
the  air-space  as  small  as  100  cubic  feet 


74  Rural  Housing 

per  pupil,  which  is,  without  question,  en- 
tirely too  low. 

Now,  as  the  air-space  allowed  each  pupil 
depends  on  the  ventilation,  and  as  this 
depends  on  the  heating  in  cold  weather, 
ventilation  and  heating  should  be  studied 
together.  The  ordinary  country  school 
will  have  to  be  heated  for  some  time  to 
come  with  a  stove,  which,  while  not  ideal, 
is  really  not  so  bad  if  a  jacketed  stove  is 
used  and  proper  means  of  distributing  the 
heat  and  admitting  fresh  air  are  arranged. 
In  the  usual  stove-heated  room,  the  floors 
are  considerably  colder  —  ten  degrees, 
sometimes, — than  the  other  parts  of  the 
room,  and  though  the  room  may  seem 
comfortable  to  the  visitor,  and  proper  ac- 
cording to  a  thermometer  placed  four  or 
five  feet  above,  yet  the  feet  get  consid- 
erably chilled  in  the  lower  temperature 
of  the  floor;  and  this  unequal  heating 
may  perhaps  help  to  account  for  the  ca- 


Overcrowded  and  Defective  Schools         75 

tarrhal  troubles  so  common  in  country 
children. 

The  space  for  admission  of  light  should 
be  about  20  per  cent  of  the  floor  space, 
according  to  those  who  have  studied  this 
matter;  yet  in  many,  very  many,  of  our 
country  schools  it  is  only  8  to  10  per  cent. 
Imperfect  lighting  certainly  leads  to  de- 
fective vision,  of  which  there  is  a  great 
deal  in  the  country  school;  more  to  be 
deplored  than  in  the  city,  as  it  is  more 
difficult  for  the  country  pupil  to  get  in 
touch  with  the  trained  oculist  and  have 
the  visual  error  corrected  than  it  is  for 
the  city  child. 

In  the  construction  should  also  be  in- 
cluded the  inadequate  and  insanitary 
toilet  arrangements;  and  while  they  are 
usually  as  good,  generally  better,  than 
the  same  appliances  in  the  surrounding 
homes,  yet  they  should  be  as  perfect  as 
our  present  knowledge  will  permit,  not 


76  Rural  Housing 

only  for  the  sake  of  the  health  of  the 
children,  but  as  a  matter  of  education  to 
the  coming  generation.  A  good  many 
people  underestimate  the  value  of  such 
things,  but  children,  with  their  receptive 
tendencies,  will  soon  take  note.  Clean 
and  bright-looking  sanitary  appliances, 
inducing  personal  cleanliness,  will  have  a 
vast  and  enduring  effect  on  the  children, 
which  will  eventually  affect  their  own 
homes  and  their  whole  life.  I  know  of 
one  instance  in  which  a  teacher's  care  to 
the  sanitary  details  of  the  toilet  so 
trained  the  children  that  not  only  did 
that  school  have  the  cleanest  toilets  in  a 
whole  county,  but  eventually  the  entire 
community  felt  the  improvement,  and  the 
sanitary  standard  for  the  whole  town  was 
raised:  of  course,  the  result  came  slowly 
and  gradually,  but  to  this  day  that  town 
owes  much  to  the  efforts  of  this  one 
teacher. 


Overcrowded  and  Defective  Schools         77 

It  must  be  very  apparent  to  any  one 
that  even  with  a  modern  school  building 
much  depends  on  the  teacher,  and  the 
ignorance  or  indifference  of  teachers  or 
directors  will  account  for  many  sanitary 
oversights.  The  care  of  the  toilets,  as 
mentioned  above,  comes  under  this  head. 
The  lighting  is  another  neglected  item, 
for  very  often,  even  with  ample  window 
space,  the  Hght  is  much  restricted  by 
shades,  many  of  which  are  out  of  order 
and  impossible  to  roll  up  completely. 

The  proper  temperature  of  a  room,  as 
every  one  knows,  or  ought  to  know,  can 
only  be  maintained  with  a  thermometer, 
yet  in  the  few  schools  having  such  an 
instrument  how  many  teachers  pay  any 
attention  to  it  or  know  its  use?  Once,  at 
least,  I  remember,  when  a  teacher  asked 
me  what  the  temperature  of  the  room 
should  be,  she  volunteered  the  informa- 
tion that  "there  was  such  a  diversity  of 


78  Rural  Housing 

opinion  among  the  directors";  and  so  it 
may  have  been. 

Much  good  may  be  done  by  the  teacher 
in  the  way  of  habits  of  personal  cleanli- 
ness. In  our  school  inspections  we  notice 
very  plainly  that  when  the  teacher  is  in 
sympathy  with  the  work  the  improve- 
ment is  far-reaching.  Take,  for  example, 
the  care  of  the  teeth.  Some  of  the  large 
manufacturing  chemists  have  made  it  a 
rule  to  send  out  to  school-teachers  sam- 
ples of  dental  paste  or  tooth-powder, 
for  the  use  of  their  pupils,  and  a  number 
of  teachers  with  whom  I  am  acquainted 
have  obtained  these  samples  and  dis- 
tributed them  among  their  pupils:  the 
children  are  then  encouraged  to  buy  a 
tooth-brush  and  use  it,  and  the  result  is 
an  array  of  clean  teeth  and  mouths  that 
would  have  been  a  wonder  a  few  years 
ago.  And  there  are  now  tooth-brushes 
in  Pennsylvania  farmhouses,  where   the 


Overcrowded  and  Defective  Schools         79 

parents  never  dreamed  of  such  an  article. 
This  kind  of  work  is  worth  encouraging, 
for  the  tooth-brush,  like  soap,  is  a  sign 
of  advancing  civilization.  No  savage  ever 
used  a  tooth-brush — nor  soap,  either. 


CHAPTER  V 

RESULTS 

What  is  the  result  of  this  overcrowding 
and  lack  of  proper  housing  in  the  country? 
Just  exactly  the  same  as  in  the  great 
cities.  Lack  of  efficiency,  disease,  and 
premature  death  to  many.  We  have  been 
talking  much  lately  of  our  conservative 
policy  of  lumber,  coal,  and  wild  animals, 
but  in  many  instances  fail  to  see  the  great 
loss  due  to  human  inefficiency  brought 
about  by  lack  of  suitable  environment. 
While  the  great  majority  of  people  sub- 
jected to  overcrowding  and  bad  housing 
conditions  do  not  prematurely  die,  yet 
they  have  a  lessened  physical  and  mental 

vigor,  less  able  to  do  properly  their  daily 

80 


Results  8 1 

work,  and  not  only  become  a  loss  to  them- 
selves and  their  families,  but  to  the  State ; 
and  forever  stand  on  the  threshold  of 
that  dread  disease — tuberculosis;  for  tu- 
berculosis is  the  one  great  disease  of  the 
overcrowded. 

Just  how  much  tuberculosis  we  have 
in  the  rural  districts  in  proportion  to  the 
great  cities  is  pretty  hard  to  say:  but 
every  one  who  has  investigated  it  is  posi- 
tive in  the  opinion  that  there  is  just  as 
much  in  the  country  districts:  indeed, 
some  report  more  in  the  country  than 
in  the  adjoining  cities.  We  find  it  in 
the  farmhouse  and  the  mountain  home: 
habits  of  carelessness  possibly  keep  up 
the  infection.  We  do  not  have  "lung 
blocks,"  like  the  large  cities,  but  we  do 
have  "lung  houses"  where  case  after  case 
of  tuberculosis  has  lived  and  perhaps  de- 
veloped. Take,  for  example,  the  house 
shown   in   Fig.  lo:    situated   far  out  in 


82  Rural  Housing 

the  country,  and  surrounded  by  as  favor- 
able conditions  as  one  could   wish,   yet 
look  at  its  record  in  three  different  and 
unrelated  families: — 
1 896-1 898. — M family:   father  died, 

mother  sick  of  tuberculosis. 
1 898-1 900. — E family:    father   and 

one  son  died  of  tuberculosis. 
190Q-1912. — L family:     father   and 

mother  died  of  tuberculosis. 
Five  deaths  from  tuberculosis  in  this 
one  house — surely  a  record  that  carries 
some  meaning  with  it ! 

Here  is  the  story  of  a  country  "lung 
house,"  which,  although  Its  occupants  be- 
longed to  one  family,  and  probably  had 
that  terrible  hereditary  tendency  to  the 
disease,  they  had  such  favorable  environ- 
ment that  improvement  in  the  resisting 
powers  of  the  various  individuals  should 
have  developed,  but  voluntary  bad  living 
kept  these  people  in  about  the  same  con- 


/ 


Results  8s 

dition  as  if  they  had  lived  in  one  of  the 
dark  and  windowless  "lung  blocks"  of  a 
great  city,  instead  of  in  an  isolated  and 
inviting  country  house  open  on  all  sides 
to  fresh  air  and  sunshine. 

T family  home  (Fig.  15) 


1880-1901. — Inhabited  by  man,  wife,  and 

six  children: 

Four  died  of  tuberculosis. 
1902-1903. — Inhabited  by  man,  wife,  and 

eight  children: 

Man  and  one  child  have  tuberculosis. 
1904. — Inhabited  by  man,  wife,  and  eight 

children : 

Four  children  have  tuberculosis :  three 
others  are  suspects. 
1905. — Inhabited  by  man,  wife,  and  two 

children : 

Man  died  of  tuberculosis. 
Eleven  cases  of  tuberculosis  in  twenty- 
five  years  in  this  nice-looking  farmhouse ! 


86  Rural  Housing 

Fig.  II  shows  a  picture  of  a  "lung 
house,"  unique  in  covering  a  period  of 
almost  fifty  years.  This  house  is  situated 
in  a  small  town  which  has  many  things  of 
historic  interest,  and  this  house,  too,  has 
a  history,  not  of  border  warfare  and  heroic 
defence,  but  a  story  of  sickness  and  death, 
perhaps  a  good  deal  of  it  avoidable.  Six 
different  families — not  related,  some  black 
and  some  white,  occupied  this  place  dur- 
ing the  last  half-century:  its  record  was 
such  as  to  attract  the  attention  of  the 
neighbors,  who  were  more  prone  to  attrib- 
ute the  fate  of  the  inmates  to  witchcraft 
than  to  the  deadly  germ  of  tuberculosis. 

C Tuberculosis  House 


1864. — James  W (C.  )  died  of  tu- 
berculosis. 

1870.— Miss  A (W.)  died  of  tu- 
berculosis. 


Results  87 

1 87 1. — Harry  C (C.  )  died  of  tu- 
berculosis. 

1872.— Miss  H (W.)  died  of  tu- 
berculosis. 

1880.— Mr.  R (C.  )  had    tuber- 

culosis: moved  away. 

1 88 1. —Mr.  W (W.)  died  of  tu- 
berculosis.  

1900. — Mr.  J (C.  )  had    tuber- 

culosis: moved  away. 

1908.— Woods  R (C.  )  died  of  tu- 
berculosis at  Mont  Alto. 

1908. — Julia  R (C.  )  died  of  tu- 
berculosis. 

1912. — Mercedes  H (C.)  died  of  tu- 
berculosis. -_-— "-^       ""^       ' 
What  a  story!    Ten  sick  of  a  lingering 

illness  and  eight  deaths.     And  then  the 

record  is  likely  incomplete;  probably  the 

story  is  only  "half  told." 

The  prevalence  of  tuberculosis  in  the 

country  is  so  evidently  marked  that  there 


88  Rural  Housing 

is  a  growing  interest  in  the  subject  in 
many  places.  The  Wisconsin  Antituber- 
culosis League,  a  year  or  so  ago,  made  a 
very  careful  and  exact  sanitary  survey  of 
a  certain  rural  district  in  that  State,  rel- 
ative to  the  amount  of  this  disease,  and 
found  that  in  some  parts  of  this  district 
the  death-rate  from  tuberculosis  exceeded 
that  of  Milwaukee,  Wisconsin's  largest 
city. 

Minnesota  also  discovered  that  it  had 
much  tuberculosis  in  its  rural  districts. 
"As  serious,"  says  Dr.  Daugherty,  who 
investigated  the  subject,  "as  that  in  the 
congested  areas  of  the  cities."  Following 
a  rural  survey  of  several  townships,  under 
the  auspices  of  the  State  Antituberculosis 
Association,  there  were  found  housing 
conditions  much  as  I  have  described  in  the 
preceding  pages  as  existing  in  Pennsyl- 
vania. "The  average  number  of  people 
sleeping  in  one  room,"  says  the  report, 


Results  89 

"was  four."  "In  one  house  there  were 
eight,  in  another  nine,  and  it  was  not  at 
all  uncommon  to  find  five  or  six.  This 
was  not  due  to  the  fact  that  there  was  not 
enough  room,  for  in  many  of  the  houses 
the  whole  family  would  sleep  in  one  room, 
use  one  for  the  kitchen,  and  leave  two, 
three,  and  in  some  cases  four,  rooms 
vacant." 

Coincident  with  this  bad  housing  there 
was  found  one  township  where  there  were 
twenty-two  deaths  from  tuberculosis  in  a 
population  of  500  in  ten  years:  a  death- 
rate  of  44  per  10,000.  These  investiga- 
tors in  Minnesota  also  found  that  "con- 
tributing causes,  as  overwork  and  poor 
food,  which  play  such  an  important  part 
among  the  inhabitants  of  the  crowded 
tenement  districts,  do  not  usually  count 
for  much  in  the  country.  Bad  housing 
and  unrestricted  exposure  to  contagion 
seem  to  be  the  great  factors."    Of  course, 


90  Rural  Housing 

in  certain  well-to-do  farming  districts, 
such  as  were  under  investigation  in  Minne- 
sota, this  would  hold  good,  but  in  many 
other  places,  especially  in  parts  of  Penn- 
sylvania known  to  the  author,  poor  food 
and  lack  of  food  are  a  vast  contributing 
cause  to  this  disease.  A  poor  constitution 
to  start  with,  and  insufficient  food,  soon 
engender  a  condition  which  quickly  yields 
to  the  inroads  of  the  bacillus.  As  a  corol- 
lary to  this  is  the  rapid  improvement  of 
such  incipient  cases,  when  put  on  the  food 
and  under  the  proper  environment  of  a 
sanatorium. 

In  illustration  of  this  food  question  the 
following  story  is  worth  repeating.  A 
visiting  nurse  was  complaining  to  a 
mother  that  her  little  daughter,  who  was 
tuberculous,  had  not  eaten  any  breakfast. 
The  mother  replied:  "Well,  it  is  her  own 
fault.  This  morning  we  had  prunes  and 
bread  and  butter,  and  that  is  good  enough 


Results  91 

for  anybody."  She  said  this,  too,  as  if 
some  of  her  other  breakfasts  were  not 
quite  so  good.  This  occurred,  not  in  a 
city,  but  in  a  country  town  where  Hving 
is  comparatively  cheap.  The  mother  was 
poor,  very  poor,  but  she  was  grossly  ig- 
norant, too,  of  foods  and  cooking.  Had 
she  given  her  child  a  bowl  of  mush  and 
milk  her  intelligence  would  have  con- 
quered her  poverty. 

And  now  a  word,  a  very  short  word, 
about  the  remedy  for  overcrowding  and 
bad  housing  in  the  country.  This  prob- 
lem can  not  be  attacked,  as  in  the  great 
cities,  by  legislative  enactment  or  resort 
to  legal  measures,  but  the  solution  lies, 
it  seems  to  me,  in  proper  education  by  the 
various  health  authorities,  by  the  schools, 
and  by  the  press,  and  the  crusade  must  be 
kept  up  until  the  people  understand  that 
it  pays — pays  in  real  dollars  and  cents — to 
live  in  sanitary  homes.    Educate  the  rural 


92  Rural  Housing 

dweller  in  regard  to  the  penalties  for  bad 
housing,  show  him  how  tuberculosis  fol- 
lows in  the  wake  of  overcrowding,  poor 
food,  and  dissipation:  in  a  great  many 
instances  he  will  mend  his  ways.  In 
Pennsylvania  this  work  is  carried  on  by 
the  Tuberculosis  Dispensaries  of  the 
State  Department  of  Health  scattered  all 
through  the  State,  where  they  have  be- 
come foci  for  spreading  sanitary  knowl- 
edge of  just  the  sort  needed  in  rural  com- 
munities. Visiting  nurses  from  these 
dispensaries  go  to  the  homes,  and  to  my 
personal  knowledge  do  much,  very  much, 
to  remedy  the  defects  of  bad  and  improper 
living,  and  do  it  without  resort  to  any 
legal  means.  There  is  no  factor  so  potent 
for  good  as  the  work  of  the  visiting 
nurses  of  this  great  health  department; 
and  many  other  States  are  taking  up  the 
work  and  carrying  it  forward  on  the  same 
lines. 


C6 


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427  Bashore  - 
p29cy  Overcrowding 
and  defective 

housing;  in  the 

rural  districts. 


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